Migraine with aura, which Brandes says occurs in about one in four patients, includes visual or sensory disturbances that usually occur before the headache. She tells Allure that some people have both types of migraine attack. “Typically, if you ever have aura with an attack, then you are labeled or diagnosed as someone who has migraine with aura,” even if you also experience migraine without aura, she explains.
The aura of a migraine usually lasts 10 to 60 minutes, and for many patients, it progresses leading up to the headache. Brandes says aura may begin with visual symptoms, like flashing lights or missing vision. Then, people may experience tingling in the face, hands, or arms, followed by difficulty with language — the feeling that you can’t get a word out even though you know it. Aura usually ends within 60 minutes, and if it goes longer, Brandes says a doctor may consider other diagnoses.
Some people can even get aura without a headache, but Brandes says that’s a separate sub-type of migraine.
People with chronic or episodic migraines and migraine with or without aura can experience any migraine subtype. Some of the most common migraine subtypes include:
Ocular migraine: According to Godley, an ocular migraine is a migraine attack, usually in one eye, where any number of visual distortions can occur for up to an hour. It may or may not occur with a headache.
“Often, an attack begins with a blind spot in the central area of vision, which can start small and get larger,” he says. “This is often followed by an aura stage with other visual distortions, such as what looks like a spot of light moving about in your peripheral and central vision, or a kaleidoscope view.”
Vestibular Migraine: Vestibular migraine, which may or may not include a headache, affects a person’s balance, causing dizziness, ear pressure, or ringing in the ears.
Godley explains that a vestibular migraine might also come with non-headache symptoms, like difficulty seeing, intolerance of bright lights and noises, neck pain and spasms, confusion, spatial disorientation, and increased anxiety. It mimics two other common balance disorders: benign paroxysmal positional vertigo and Meniere’s disease.
Hemiplegic Migraine (HM): People with hemiplegic migraine experience motor weakness during their aura, which Godley tells Allure is the main differentiating factor between HM and other migraine classifications.